How Physical Disabilities and Mental Health Intersect

By Adrian Johansen

IIf life during a pandemic has taught us anything, it's how precious and fragile health truly is. But when you are living with a disability, this is a lesson you didn't need COVID-19 to teach you.

The reality is that whether the condition is an injury or a physical or mental illness, living with a disability fundamentally shapes your life experiences. But accepting, and even embracing, one's disability as a facet of one's identity doesn't mean submitting to a defeatist mindset.

It is possible to accommodate your experiences with injury and illness into a healthy sense of self, enabling your disability to shape who you are. It begins, though, by understanding the relationship between disability and mental health.

Mental Health and Disability

Photo credit: Pixabay

Disability and Society

There is a significant body of evidence that persons with disabilities are at an increased risk for suicide or suicidal ideation. However, the evidence also shows that it isnot the disabling condition per se that most often leads to suicidal impulses.

Rather, it's the social constraints that so many people with disabilities regularly face that can lead to life-threatening depression. Research shows, for example, people with disabilities encounter tremendous obstacles to "normal" social functioning that have little or nothing to do with the injury or illness itself. This includes barriers that are both structural and ideological, from limited access to public transportation or curbside cutouts for wheelchair-users to the lack of flexible work options for persons who might need it.

Persons with visible disabilities, for instance, report that they often experience various forms of discrimination when out in public. This includes the tendency for strangers to use the high-pitched tones often reserved for infants when speaking to adults with disabilities, to speak to the person's companion or attendant rather than to the person him or herself, or to refer to persons with disabilities as "admirable" or "courageous." 

In the workplace, the misconception that hiring a person with a disability would require prohibitively expensive accommodations, or simply that a person with an injury or illness would not be able to be as productive or reliable as a non-disabled employee, contributes to the disproportionately high rates of unemployment among persons with disabilities. In fact, according to recent estimates, the November 2020 labor participation rate for adults with disabilities was 33%, compared with 75% for non-disabled adults in the same period.

What this all boils down to is a social structure that prohibits the full participation of persons with disabilities. Physical barriers, pervasive stereotyping and the lack of labor participation are, in essence, a perfect storm, all too frequently setting persons with disabilities apart from the rest of society, limiting their choices, opportunities and engagement—and, in the end, contributing to an increased risk of depression and suicide.

Managing Isolation, Stigmatization and Depression

Despite all the diverse challenges described above, life with a disability does not have to mean a life of unhappiness, isolation or loneliness. From college campuses to cities and communities across the nation, advocacy groups are helping to make enormous strides in educating the public and decreasing barriers to inclusion and participation. Life on a college campus, for example, can be profoundly isolating, particularly if you are one of the millions of students experiencing both physical and mental health challenges. Advocacy groups, however, can make all the difference when it comes to raising awareness and supporting inclusion.

Above all, persons with disabilities are increasingly thriving in the world, volunteering, engaging, and living full lives, even in the face of such structural and ideological barriers. Finding engagement and purpose are essential in overcoming isolation and combatting depression, no matter who you are, whether you have a disability or not. We all need to feel needed, after all. And the best cure for loneliness is simply not to be alone—to get out and about even when you don't necessarily want to. Interacting with humans and animals are perfect ways to get out of your head, and out of your funk, and rejoin the world.

Managing Depression

All this is not to suggest, however, that it's always easy. Having to work so much harder than non-disabled persons to enjoy the same level of opportunity and engagement is downright unfair. There's no getting around that.

But an even greater injustice would be for these inequities to deprive you of the life you want and deserve. To achieve it, though, you may need specialized support.

Unfortunately, because rates of unemployment are so high among the disabled population, lack of quality healthcare coverage is also a significant concern, particularly for those who may not qualify for Medicaid or Medicare. If you are among the uninsured or underinsured, a nurse-managed healthcare clinic can be a wonderful resource for accessing affordable, quality care, including mental health care services.
In addition to accessing community health and social support services, exploring alternative therapeutics to promote both physical and mental health is essential. For example, there's mounting evidence therapeutic cannabis can be used to relieve anxiety and depression.

This is attributed not only to the THC in therapeutic cannabis but also, and perhaps even more importantly, to the high levels of CBD in these substances. CBD, unlike THC, does not produce psychotropic effects, but still produces significant effects on the body's endocannabinoid system—the body's primary "feel good" system, responsible for its sense of both physical and mental wellbeing.

The Takeaway

There is a significant connection between disability and mental health, but that connection is far more complex than it might at first seem. It's rarely about the illness or injury itself, but rather about the social and ideological barriers that make full engagement in our communities so difficult. It's about having to fight for opportunities that non-disabled persons may take for granted. But the result is a rich, full and joyous life alongside of your challenges. It just means you may need to take special care and seek support when you need it.

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